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NMA/NCMM Approved Doctors' Meeting 2014 
Kjell Grøndahl, M.Sc. Dept of Medical Engineering Haukeland University Hospital Bergen, Norway 
TESTING SEAFARERS HEARING CAPACITY WHILE USING HEARING AIDS
INTERNATIONAL LABOUR OFFICE / INTERNATIONAL MARITIME ORGANIZATION, 2013
APPENDIX B: HEARING STANDARDS
UNAIDED HEARING 
PTA «Pure Tone Average» max: 30 dB in the better ear and 40 dB in the less good ear 
Measured at the frequencies 500, 1000, 2000 and 3000 Hz.
AUDIOGRAM 
Left 
Right 
Is this an acceptable hearing loss?
PURE TONE AUDIOMETRY 
•Independent of language 
•Standardized equipment and methods 
•Not suitable for testing with hearing aids 
•Does not measure speech recognition
SPEECH AUDIOMETRY
SPEECH AUDIOMETRY 
•Routine test in many countries 
•Calibration issues: Values for sound field (loudspeaker) may not be available. 
•Difficult to compare across languages 
•Speech without background noise is not representative for normal working conditions
AIDED HEARING 
Appendix B: ”Alternative assessment methods using validated and standardized tests that measure impairment to speech recognition are also acceptable.”
AIDED HEARING 
Testing with headphones not possible 
We want to test speech recognition in realistic conditions (background noise)
Speech 
Noise 
SPEECH-IN-NOISE (SIN) TEST 
Result: The speech/noise ratio (SNR) where 50% of the words are repeated correctly
Speech 
Noise 
SPEECH-IN-NOISE (SIN) TEST 
Example: 
67 dB 
65 dB 
SNR: + 2 dB 
Sound examples: people.kth.se/~e99_ehe/project.html
SPEECH-IN-NOISE (SIN) TEST 
Many different methods in use. Manual, adaptive, single- speaker, multi-speaker, different types of noise. But they all measure the SNR at 50 %.
AVAILABLE TESTS 
•Validated tests are available in many languages 
•A few tests are standardized and available in more than one language. One of the most common is HINT (Hearing In Noise Test) from House Ear Institute. 
•Some require proprietary equipment 
•Often used to evaluate the fitting of hearing aids 
•Main users: University hospitals, hearing aid dispensers
WHAT SHOULD BE AN ACCEPTABLE RESULT? 
According to the guidelines: 
“Hearing aids are only acceptable in serving seafarers where it has been confirmed that the individual will be capable of safely and effectively performing the specific routine and emergency duties required of them”
WHAT SHOULD BE AN ACCEPTABLE RESULT? 
SIN tests are validated using young, normal-hearing subjects. We can compare the results to this reference (similar to the audiogram) We assume that the validation measurements follow a normal distribution. A reasonable «rule of thumb» may be using the 5 % percentile or 2 standard deviations (= 2.3 % percentile). The requirements of the actual workplace must be taken into consideration.
WHAT SHOULD BE AN ACCEPTABLE RESULT?
REFERENCES 
Audiogram figure: Public Domain (Wikipedia / User:Carnildo). Hearing loss example by Kjell Grøndahl 
Hearing aid image: Oticon 
Speaker setup illustration: HINT test, House Ear Institute 
Sound examples: people.kth.se/~e99_ehe/project.html 
(Dept. of Speech, Music and Hearing, KTH, Sweden)
Session 2 7  - grøndal k - hearing test - seafarers ver2

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Session 2 7 - grøndal k - hearing test - seafarers ver2

  • 1. NMA/NCMM Approved Doctors' Meeting 2014 Kjell Grøndahl, M.Sc. Dept of Medical Engineering Haukeland University Hospital Bergen, Norway TESTING SEAFARERS HEARING CAPACITY WHILE USING HEARING AIDS
  • 2. INTERNATIONAL LABOUR OFFICE / INTERNATIONAL MARITIME ORGANIZATION, 2013
  • 4. UNAIDED HEARING PTA «Pure Tone Average» max: 30 dB in the better ear and 40 dB in the less good ear Measured at the frequencies 500, 1000, 2000 and 3000 Hz.
  • 5. AUDIOGRAM Left Right Is this an acceptable hearing loss?
  • 6. PURE TONE AUDIOMETRY •Independent of language •Standardized equipment and methods •Not suitable for testing with hearing aids •Does not measure speech recognition
  • 8. SPEECH AUDIOMETRY •Routine test in many countries •Calibration issues: Values for sound field (loudspeaker) may not be available. •Difficult to compare across languages •Speech without background noise is not representative for normal working conditions
  • 9. AIDED HEARING Appendix B: ”Alternative assessment methods using validated and standardized tests that measure impairment to speech recognition are also acceptable.”
  • 10. AIDED HEARING Testing with headphones not possible We want to test speech recognition in realistic conditions (background noise)
  • 11. Speech Noise SPEECH-IN-NOISE (SIN) TEST Result: The speech/noise ratio (SNR) where 50% of the words are repeated correctly
  • 12. Speech Noise SPEECH-IN-NOISE (SIN) TEST Example: 67 dB 65 dB SNR: + 2 dB Sound examples: people.kth.se/~e99_ehe/project.html
  • 13. SPEECH-IN-NOISE (SIN) TEST Many different methods in use. Manual, adaptive, single- speaker, multi-speaker, different types of noise. But they all measure the SNR at 50 %.
  • 14. AVAILABLE TESTS •Validated tests are available in many languages •A few tests are standardized and available in more than one language. One of the most common is HINT (Hearing In Noise Test) from House Ear Institute. •Some require proprietary equipment •Often used to evaluate the fitting of hearing aids •Main users: University hospitals, hearing aid dispensers
  • 15. WHAT SHOULD BE AN ACCEPTABLE RESULT? According to the guidelines: “Hearing aids are only acceptable in serving seafarers where it has been confirmed that the individual will be capable of safely and effectively performing the specific routine and emergency duties required of them”
  • 16. WHAT SHOULD BE AN ACCEPTABLE RESULT? SIN tests are validated using young, normal-hearing subjects. We can compare the results to this reference (similar to the audiogram) We assume that the validation measurements follow a normal distribution. A reasonable «rule of thumb» may be using the 5 % percentile or 2 standard deviations (= 2.3 % percentile). The requirements of the actual workplace must be taken into consideration.
  • 17. WHAT SHOULD BE AN ACCEPTABLE RESULT?
  • 18. REFERENCES Audiogram figure: Public Domain (Wikipedia / User:Carnildo). Hearing loss example by Kjell Grøndahl Hearing aid image: Oticon Speaker setup illustration: HINT test, House Ear Institute Sound examples: people.kth.se/~e99_ehe/project.html (Dept. of Speech, Music and Hearing, KTH, Sweden)